Checklist for Accurate Office BP Measurement

September 16, 2020
Grace Halsey

Office blood pressure measurement technique is relatively simple yet widely prone to error. Check your office procedure against guideline recommendations.

Blood pressure (BP) measurements taken in the clinic setting are subject to a wide range of errors in technique -- however, office BP is still the most commonly used method to diagnose hypertension and to monitor patient response to therapy.

Recent observational studies have found that basic tenets of best practice such as specific seating and posture in a chair and a 5-minute rest period before measurement is taken were followed in only half of practices included. In another study, BP was significantly lower when patients were seated in a chair vs sitting on the exam table in 43.5% of subjects. Compared with BP measured on the table, about 5% of patients would have been misclassified as having elevated BP, and 20.1% of patients would have been misclassified as having hypertension.

As a quick review on "how to," we summarize a short section of the 2017 ACC/AHA Guideline for Prevention and Management of High Blood Pressure in Adults in these slides.